Image by GERVASIO RUIZ
Written by Kathy Drzewiecki. Reviewed by Erin Lawton, PsyD, LP.
When we hear the word menopause (the point at which a woman has missed 12 consecutive menstrual cycles), most of us think of hot flashes, night sweats, and unpredictable cycles. But there’s a whole other side to this transition that doesn’t get nearly as much attention—the emotional ups and downs and the way our brains feel during this time. Ever walked into the kitchen and completely forgotten why you went there in the first place? Or felt perfectly fine one minute, then suddenly irritated (or in tears) the next? If so, you’re definitely not alone.
Why? The Hormone Roller Coaster!
During perimenopause (period that can last up to 10 years preceding menopause), estrogen and progesterone start to fluctuate like a roller coaster that goes off track. These hormones don’t just affect your menstrual cycle. They are also important to mood, memory, sleep, and our ability to handle stress. When estrogen and progesterone start dropping, the brain functions that rely on those chemicals can also go off track.
Image by StockSnap
The Emotional Shifts
Mood Swings That Come Out of Nowhere
One moment you’re laughing at a funny video; the next, you’re tearing up over a commercial. That’s because shifting estrogen levels affect the brain chemicals that help steady our moods. When those levels dip, it can feel like someone is messing with the dials on your emotions without warning.
When Sadness Shows Up
About one in four women notice an increase in depressive feelings during this time—things like sadness, feeling low, or just not feeling like yourself. While new experiences of long-lasting symptoms of clinical depression (called major depressive disorder) are not common in this stage, these less severe emotional dips can still feel pretty heavy.
Anxiety and the “What If” Spiral
Some people notice more worry or increased irritabiility. You may even notice becoming extremely annoyed by situations that previously wouldn’t have bothered you. Decreases in estrogen and progesterone during perimenopause can lead to increased symptoms of anxiety. And when you add other life stressors—caring for kids or parents, juggling work—it can feel overwhelming at times.
Image by Mircea Iancu
The Cognitive Changes – Hello, “Brain Fog”
Memory Glitches
If you’ve ever stopped mid-sentence because you forgot what you were about to say, or walked into a room and thought, “Wait, what was I doing?”, that’s the brain fog talking. These memory hiccups are tied to the estrogen dips that affect the memory-supporting parts of your brain. The good news? This fog usually clears up in post- menopause (the period of time following 12 consecutively missed periods).
Focus Takes a Hit
Many women find that it is harder to multitask or tackle complicated tasks. It’s not your imagination: it’s part of the hormonal shifts. Up to two-thirds of women report difficulties with concentration during perimenopause, so if you feel like you’re not as sharp as you used to be, you’re far from alone.
Sleep (or the Lack of It)
Hot flashes, night sweats, or just plain restlessness can make good sleep elusive. Up to 46% of women report difficulties falling asleep, staying asleep, or waking up too early. Snoring and sleep apnea also become more common both during and after the menopause transition. Unfortunately, lack of sleep can make brain fog, irritability, and mood swings even worse.
How to Support Yourself
- Prioritize Sleep: Try to keep your bedroom cool and stick to a regular sleep routine.
- Move Your Body: Even a short walk can boost mood and brain function.
- Mind-Body Practices: Things like yoga, meditation, or deep breathing can help calm that overactive stress response.
- Work With Your Health Care Provider: Options are available to help you through this transition.
Contact us at Nowlogy: If you’re feeling overwhelmed during this life stage, we’re here to help with evidence-based treatments for sleep, coping, and relationship difficulties.
Kathy Drzewiecki | Postdoctoral Fellow
Currently completing her Psy.D. at Spalding University in Louisville, KY, Kathy has experience across community mental health, inpatient hospitals, college counseling centers, private practices, and trauma-focused organizations. She uses a range of evidence-based approaches, including ACT, CBT, DBT, IPT, and CPT, to help clients build meaningful, fulfilling lives.
